Type 2 Diabetes and mental illness

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Mental illness is enough to cope with on its own, so being told you have diabetes as well can feel overwhelming at first. It’s important to remember, then, that there are things you can do yourself to manage the condition well, and that there are trained people who can help you do this – for example, by recommending eating and lifestyle changes.

Getting used to a diagnosis of diabetes can take a while, and just as there is stigma around mental illness, so there can be stigma around Type 2 diabetes. You may feel that some people think it’s your fault that you developed diabetes, that it was caused by eating too much and not exercising. However, diabetes is more common among people living with a mental illness. Antipsychotic medications can lead to major weight gain, for example, while depression and anxiety can make it more difficult to exercise regularly and eat healthily because of the effects on motivation.

It is important for you, your family and friends to find out what you can about diabetes, to understand what support is available, and what you can do to help yourself.

What can I do about my diabetes?
Start by finding out about reliable sources of information and support. Most people know someone with diabetes, but it doesn’t mean they know what’s best for you to do, or anything about your mental illness. Good mental health and controlling the symptoms of mental illness are especially important when learning to manage diabetes.

A good doctor will look after your overall health, monitor your medication, and keep in contact with your mental health team as necessary. Making a longer appointment time helps build a relationship with your doctor, by giving you a chance to talk in more detail about your health and how you feel. It often helps to write down your questions or take a friend, support worker or family member to the appointment with you, to help you remember what to ask and what the doctor said.

What can I expect?

The aim of diabetes management is to keep blood glucose levels as close to normal as possible. Regular checks of blood glucose are needed to see if the balance in your body is right. In the early stages, diabetes can be managed with a healthy diet and regular exercise. Over time, diabetes can change and medication may be needed. This medication doesn’t replace exercise and healthy eating, which are still good for your mental and physical health. If your body stops making its own insulin you may then need to take synthetic insulin. Needing insulin is not a sign of failure that you have failed to manage your diabetes, as the condition can naturally develop this way.

Making a plan
When you are ready, your GP or other health professional can help you make a plan of small, achievable steps to improve your physical health, while maintaining your mental health. A plan can help you work through the changes, one step at a time. A diabetes management plan may include referrals to other health professionals to help you be as healthy as possible. Diabetes can affect many areas of your body, the following people can help:

  • A diabetes educator helps you manage your diabetes. They can meet with you regularly and help with issues as they happen.
  • They are a great help when learning to test blood glucose.
  • A dietitian helps you develop ways of eating more healthily if you find changes are difficult.
  • Exercise is an important part of managing your diabetes. An exercise physiologist can provide you with advice on physical activity and things you need to consider about exercise, to help you improve the way you feel.
  • Your GP will refer you to an optometrist or eye specialist who can give you regular eye tests, so any eye problem that may develop can be picked up and treated early.
  • Your GP or a podiatrist can check your feet regularly as poor circulation may be an issue.

Your pharmacist will be able to help manage the different medications you may be taking and help with possible side-effects. When you are already taking one or more medications for your mental illness, you may feel overwhelmed by new medication for your diabetes. Using a calendar, timer or pill box helps you remember what to take and when.

Your GP, dentist and other health workers will continue with your regular health checks.

Medicare and the National Diabetes Service Scheme will cover most of the costs for these health appointments, blood glucose testing equipment and medication. You can find out more from Medicare and Diabetes Australia (contact details below). If you need to use an inpatient mental health service, talk to the staff about your diabetes management or ask your GP or support person to do this. The same applies to treatment for your mental illness if you go to hospital for diabetes care.

It’s important for everyone to be active and eat healthily, and this is especially true if you have a mental illness or diabetes. Physical activity and healthy eating help you to feel better and directly improve your diabetes as well.

Tips: being more physically active

  • Walking to the shops instead of taking the car or getting a lift
  • Using the stairs rather than a lift or escalator
  • Cycling, swimming, or regular walking
  • Tai chi, yoga or other relaxing and strength-building activity
  • Gardening, washing the car or cleaning the house.

Build up to 30 minutes activity per day. This doesn’t have to be all at once. Walking to the bus, doing some housework and carrying your shopping home will easily add up to half an hour a day. Comfortable, supportive shoes will make this easier. You’ll know you are exercising at the right pace when you are breathing faster but are still able to have a conversation. Remember to tell your doctor before you start an exercise program, as this may affect your medication.

Smoking affects your ability to be active, as well as being dangerous to your health in many other ways. Your GP, Quit, or the SANE Helpline can provide information and what support and resources will help you stop smoking. The  SANE Guide to a Smokefree Life is a guidebook specially written to help people affected by mental illness to quit smoking.

Tips: eating more healthily

When you develop diabetes you become more aware that what you eat affects your health. Healthy eating can delay having to take extra diabetes medication. It can also maintain your weight or counteract weight gain from medication for mental illness. Ask a diabetes educator and dietitian for advice – they are experts in helping you to eat more healthily. Diabetes Australia also have information sheets on this topic. Examples of eating healthily include:

  • Smaller regular meals throughout the day with a mix of wholemeal breads, pasta and basmati rice; a palm-sized amount of eggs, meat, fish or other protein; vegetables or fruit
  • Low-fat cooking methods such as grilling, boiling, steaming and barbecuing instead of frying
  • Drinking tap water instead of sugary (and costly) drinks
  • Limiting or avoiding food that is high in fat, sugar and alcohol.

Developing healthy habits
Things get easier once they become a habit. When you become used to small changes in your lifestyle, you find they become part of your daily routine.  If you do slip up – skip a walk or eat some fast food, for example – don’t think you’ve failed. Look at how far you’ve come and what you want to achieve, and just start again. Look for the support you need to be healthier.

Find out more

SANE Helpline
1800 18 SANE (7263)

Diabetes Australia
1300 136 588

131 848

132 011

To order any of the SANE Guides mentioned on this Factsheet visit the SANE Bookshop at www.sane.org or call 1800 18 SANE (7263).

SANE Australia . . . Type 2 Diabetes and mental illness

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This Factsheet may be freely downloaded, copied and distributed on condition no change is made to the contents. SANE Australia is not responsible for any actions taken as a result of information or opinions contained in the Factsheet. (Version English, 2014)